{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:56:30Z","timestamp":1790996190462,"version":"4.1.0"},"reference-count":39,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Key Scientific Research Project of Higher Education Institutions in Henan Province","award":["26A320058"],"award-info":[{"award-number":["26A320058"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association between early concentrated 8.4% sodium bicarbonate and subsequent in-hospital mortality in patients with cardiogenic shock, severe acidemia, and hyperlactatemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective two-hour landmark cohort study using the single-center MIMIC-IV v3.1 database. True time zero was the first time pH \u22647.20 and lactate \u22654 mmol\/L were both known within a two-hour pairing window. Patients with pre-time-zero bicarbonate exposure, renal replacement therapy, or diabetic ketoacidosis were excluded. Patients alive and still hospitalized at two hours were classified according to 8.4% sodium bicarbonate administration during the 0- to 2-hour window. Propensity-score overlap weighting was used to balance baseline covariates. The primary outcome was subsequent in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 489 landmark patients, 110 received early 8.4% bicarbonate and 379 did not. After overlap weighting, the maximum absolute standardized mean difference was 0.091. Weighted mortality was 80.4% with early bicarbonate versus 70.2% without early treatment, corresponding to a risk difference of 10.2 percentage points (95% CI, \u22120.1 to 20.4; P=.052) and a risk ratio of 1.145 (95% CI, 1.001\u20131.310; P=.049). Sensitivity analyses showed broadly consistent point estimates, although confidence intervals and target overlap populations varied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early 8.4% sodium bicarbonate did not demonstrate a survival benefit among patients who survived to the two-hour landmark. Estimates were directionally compatible with higher mortality, but residual confounding and statistical uncertainty preclude a causal conclusion of harm.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00368504261492494","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:38:29Z","timestamp":1790678309000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early 8.4% sodium bicarbonate and in-hospital mortality in cardiogenic shock with severe acidemia and hyperlactatemia: A two-hour landmark overlap-weighted retrospective cohort study"],"prefix":"10.1177","volume":"109","author":[{"given":"Xingwei","family":"Wang","sequence":"first","affiliation":[{"name":"Fuwai Central China Cardiovascular Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Gao","sequence":"additional","affiliation":[{"name":"Fuwai Central China Cardiovascular Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingbo","family":"Shi","sequence":"additional","affiliation":[{"name":"Fuwai Central China Cardiovascular Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2979-8457","authenticated-orcid":false,"given":"Cao","family":"Ma","sequence":"additional","affiliation":[{"name":"Fuwai Central China Cardiovascular Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahui","family":"Liu","sequence":"additional","affiliation":[{"name":"Fuwai Central China Cardiovascular Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2023.05.001"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.01.018"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2300323"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.023322"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11247295"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-021-03677-4"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2023.04.012"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-112-7-492"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03431-2"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31080-8"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.20231"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-025-07979-x"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.1059285"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.974271"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.665907"},{"issue":"1","key":"e_1_3_7_17_2","first-page":"67","article-title":"Early metabolic acidosis in critically ill patients: a binational multicentre study","volume":"23","author":"Mochizuki K","year":"2021","unstructured":"Mochizuki K, Fujii T, Paul E, et al. 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